Nine million Americans get both Medicare and Medicaid benefits simultaneously. They consume a disproportionate share of program resources.

It's perfectly legal to be a so-called "dual-eligible" and pull from both programs. But in 2008, the latest data year available, these nine million Americans comprised 20 percent of Medicare clients but accounted for 31 percent of Medicare spending ($132 billion). They were only 15 percent of Medicaid clients, but took up 39 percent of Medicaid funds ($129 billion).

Dual-eligibles tend to be both low-income and elderly and their population varies widely by state.